Electrosurgical device

ABSTRACT

A radio-frequency electrosurgical device which includes an active electrode, a passive electrode, and means for generating a radio-frequency potential. The generating means induces the radio-frequency potential on a primary winding of an isolation transformer. The secondary winding of the isolation transformer powers the active electrode. One end of the secondary winding of the isolation transformer is coupled to a return lead connected to the passive electrode and also is coupled to ground through a primary winding of a second transformer. If the passive electrode is disconnected from the return line, there can be an alternate radio-frequency current return path to ground, and a potential is developed across the primary winding of the second transformer. This potential is used to energize a relay to actuate an alarm and to disable the radio-frequency generator if the passive electrode becomes disconnected.

This invention relates to an electrosurgical device. The device of this invention represents an improvement in the type of device shown in my co-pending application Ser. No. 461,983 filed Apr. 18, l974, now U.S. Pat. No. 3,905,373.

In radio-frequency electrosurgical devices, a passive electrode is used having a broad face engaging a patient's skin surface. A radio-frequency potential is set up between an active electrode and the passive electrode. It is essential that the connections to the passive electrode be unbroken to avoid danger to the patient by unintended alternate radio-frequency current return paths from the patient. Such unintended radio-frequency current return paths can cause radio-frequency skin burns on the patient or to operating room personnel. Various systems have been devised to monitor the integrity of a passive electrode radio-frequency return current path system using direct or low frequency interrogation currents, which can conduct through the patient under some circumstances. Such interrogation currents can be dangerous to the patient, and an object of this invention is to provide a monitoring system which does not require an unsafe interrogation monitoring current which, when present, may pass through the patient.

If a passive electrode is not properly electrically linked to a return line in such a device, there can be an unintended alternate current path return to ground, and a radio-frequency potential is set up between the patient return line and ground. A further object of this invention is to provide a monitoring system which uses this potential to signal that there is a passive electrode return line failure present.

A further object of this invention is to provide such a monitoring system which shuts off the electrosurgical device if a predetermined radio-frequency potential is set up between the patient return line and ground.

Briefly, this invention provides a radio-frequency electrosurgical generator device which includes an isolation transformer which has a primary winding in which a radio-frequency potential is set up. One end of a secondary winding of the isolation transformer is coupled to a passive electrode and also is coupled to ground through a primary winding of a second transformer. A secondary winding of the second transformer operates a relay having contacts which disconnect a power lead to driver oscillators of the device and actuates a buzzer horn and a warning signal light when the predetermined radio-frequency potential is set up.

The above and other objects and features of the invention will be apparent to those skilled in the art to which this invention pertains from the following detailed description and the drawings in which:

FIG. 1 is a simplified schematic circuit diagram of a radio-frequency electrosurgical device constructed in accordance with an embodiment of this invention; and

FIG. 2 is a schematic circuit diagram of a radio-frequency electrosurgical device constructed in accordance with another embodiment of this invention.

In the following detailed description and the drawing, like reference characters indicate like parts.

In FIG. 1 is shown schematically a wiring diagram for a radio-frequency electrosurgical device constructed in accordance with an embodiment of this invention. A radio-frequency potential is impressed by a radio-frequency generator 402 (not shown in detail) between a ground lead 403 and a power lead 404. The radio-frequency potential is impressed on a primary winding 406 of an isolation transformer 407 through a condenser 408. A secondary winding 409 of the transformer 407 is connected to a coaxial cable 411 through a condenser 412. The cable 411 powers an electrosurgical handpiece 413 which includes a handpiece primary winding 414 and a condenser 416 in series between a central power lead 417 and an outer return lead 418 of the cable 411. A handpiece secondary winding 419 supplies power to a surgical electrode 421. A passive electrode 422 is coupled to the other end of the secondary winding 409 through a lead 423 and a condenser 424. A patient 425 is in electrical contact with the passive electrode 422. In ordinary use of the electrosurgical device, electrical return from the active electrode is through the patient 425, the passive electrode 422, the lead 423 and the condenser 424 to the secondary winding 409. An alternate radio-frequency path return lead 427 is connected to the other end of the secondary winding 409 through a condenser 428. The alternate radio-frequency current path return lead 427 is connected to ground through a primary winding 429 of a transformer 431. A secondary winding 432 of the transformer 431 is connected to a relay inductance 433 through a rectifier 435 and to a filter condenser 439. Relay contacts 434 and 436 can be connected to actuate an alarm 437 when the relay 433 is actuated. An appropriate source of voltage 438 is connected in series with the relay contacts 434-436 and the alarm 437 to power the alarm 437 when the relay contacts 434-436 are closed. When the relay inductance 433 is energized, relay contacts 441-442 close to operate a hold-in circuit powered by a battery 443 so that the alarm 437 continues to be actuated once the relay inductance 433 has been energized.

A dangerous condition can occur if the lead 423 becomes electrically broken or is electrically disconnected from the passive electrode 422. In this event, the radio-frequency electrical return can be by an unintended alternate radio-frequency current path such as an alternate path 446 from the patient 425 to ground. when the radio-frequency electrical return is by way of the alternate path 446, the return is through the primary winding 429, the lead 427, and the condenser 428 to the other side of the secondary winding 409 of the cable 411 so that the relay 433 is energized. The relay is shown connected to actuate the alarm 437, but the relay 433 can be connected to turn off power to the radio-frequency generator 402 to shut off the electrosurgical device.

In FIG. 2 is shown schematically the wiring diagram of a radio-frequency electrosurgical device constructed in accordance with another embodiment of this invention. Alternating current power is supplied by power leads 11 and 12. A grounding line 13 is connected to an appropriate system ground such as a water pipe 14 and/or to an appropriate operating room grounding system. The power lead 12 can also be connected to ground as indicated by a dashed line 812. The grounding line 13 is connected to one side of a primary winding 16 of a transformer 17. The other side of the primary winding 16 is connected to an alternate path return lead 511 which is connected through a condenser 512 to an outer conductor 68 of a coaxial cable 18. When a radio-frequency potential is set up between the ground 14 and the outer conductor 68, a potential is set up by a transformer secondary winding 518 of the transformer 17 between leads 23 and 24.

The power lead 11 is connected through a power line fuse 118 and an interlock switch 119 to a lead 122. The interlock switch 119 is closed during operation of the device but can be arranged to open when a casing of the device (not shown) is opened. The power lead 12 is connected to a lead 121.

The leads 121 and 122 are connected to poles 123 and 124, respectively, of a triple pole double throw on-off switch 126. When the on-off switch 126 is in the position shown (off position), the leads 121 and 122 are connected to power a primary winding 127 of a transformer 128 to impress a low voltage such as 4 volts across a secondary winding 129 thereof. When the on-off switch 126 is in its other position (on position), the leads 121 and 122 are connected to a primary winding 1291 of a transformer 130 to power the transformer 130. A panel light 131 is connected in parallel with the primary winding 1291 to indicate that the primary winding 1291 is powered. A thermally activated circuit breaker 1292 in series with the primary winding 1291 protects the transformer 130. A third pole 132 of the switch 126, when in the on position, connects leads 133 and 134 to connect one side of a heater electrode 135 of a tetrode main power amplifier tube 136 to one side of a first secondary winding 137 of the transformer 130, which can be constructed to supply approximately 6 volts AC to the heater electrode 135. A capacitor 2135 is connected between the line 133 and ground to shunt any raido-frequency current from the heater electrode 135. The other side of the first secondary winding 137 is connected to ground as is the opposite side of the heater electrode 135. A fan motor 1371 is connected in parallel with the primary winding 1291 to drive a fan 1372 which blows air on the tetrode 136 and other components to cool the tetrode and other components. When the on-off switch 126 is swung to its off position, the pole 132 connects the lead 133 to the secondary winding 129 of the transformer 128 so that the heater electrode 135 is heated not only when the on-off switch 126 is in the on position but also when the on-off switch 126 is in the off position. As already pointed out, the secondary winding 129 of the transformer 128 can be arranged to deliver about four volts so that the heater electrode 135 is heated but at a lower temperature when the switch 126 is in the off position but is maintained at a sufficient temperature that the device will operate at once when the switch 126 is turned on.

A secondary winding 146 of the transformer 130 supplies a voltage of approximately 2000 volts AC across leads 147 and 148 to a full wave bridge rectifier 149 which supplies 2000 volts direct current across leads 150 and 151. The lead 150 is connected to ground as is a cathode 152 of the tetrode 136. The lead 151 is connected through a plate choke 153 and a parasitic suppressor network 154 to a plate 156 of the tetrode 136 so that 2000 volts DC is impressed between the cathode 152 and the plate 156 of the tetrode 136. A filter condenser 157 smooths out wave form ripple from the rectifier 149. A tapped resistor 159 and a fixed resistor 159A are connected in series across the leads 150 and 151. A lead 158 connected to the tap of the tapped resistor 159 supplies a positive potential through a resistor 161 and a lead 162 to a screen grid 1620 of the tetrode 136. A voltage of approximately 380 volts can be taken off at the tap, which is maintained on the screen grid. An appropriate resistance 164 bleeds off screen grid current to ground. A capacitor 166 connected between the screen grid lead 162 and ground removes or shunts out radio-frequency from the screen grid. Zener diodes 3000 and 3001 connected in series suppress voltage transients and regulate the maximum steady state voltage on the screen grid 1620.

A section 146A of the second secondary winding 146 of the transformer 130 is connected in parallel with a capacitor 146B to form a tuned circuit tuned to a line input frequency, which can be 60 Hertz, to stabilize the secondary winding voltages to a variation of approximately ±1% with a change in input voltage of ±10% impressed on the primary winding 1291. Thus, the transformer 130 is a substantially constant voltage transformer stabilizing all the circuitry of the device.

A bias voltage for a control grid 168 of the tetrode 136 is supplied by a third secondary winding 169 of the transformer 130. A first lead 171 from the winding 169 is connected to ground and a second lead 172 from the winding 169 is connected to a rectifier 173. The rectifier 173 supplies a negative potential through a resistance 1741 and an inductance 1742 to a lead 174, which is connected to one end of a first series winding 176 of a transformer 1761. The other end of the winding 176 is connected through a second series winding 1762 of the transformer 1761 to a lead 179 connected to the control grid 168 of the tetrode 136. A condenser 181 which is connected between ground and a junction 1743 smooths out the wave form of the potential from the rectifier 173. A resistance 183 connected in parallel with the condenser 181 serves to discharge the condenser 181 when the device is turned off. The bias voltage can be approximately -120 volts.

Oscillator circuits 184 and 186 for the device are powered from a fourth secondary winding 187 of the transformer 130. Leads 188, 189 and 190 from the winding 187 are connected through a single pole double throw switch 191 to a full wave bridge rectifier 192 which supplies a DC voltage across leads 193 and 194. When the switch 191 is in the position shown, a voltage of approximately 16 volts is supplied across the leads 193 and 194. When the switch 191 is in its other position, a voltage of approximately 25 volts is supplied across the leads 193 and 194. A condenser 195 connected across leads 193 and 194 smooths ripple voltage. A resistance 1961 connected across the leads 193 and 194 discharges the condenser 195 when the device is turned off. The lead 193 is connected to ground. The lead 194 is a main power lead and normally is connected through normally closed contacts 311 and 312 of a relay 31 and a lead 321 to the pole of a single pole double throw switch 196. When the switch 196 is in the position shown, the lead 321 is connected through a short lead 197 to the pole of a single pole double throw switch 198. The switches 196 and 198 can be foot operated switches. The switches 196 and 198 are shown in their normal positions. When the switch 196 is turned to its other position, the main power lead 194 is connected to a lead 199. When the switch l98 is turned to its other position, while the switch 196 remains in the position shown, the main power lead 194 is connected to a lead 200. If the switches 196 and 198 are both turned to their other position, the lead 194 is connected to the lead 199, and it is impossible to connect both the leads 199 and 200 to the lead 194 at the same time. The lead 199 is connected to one side of a potentiometer 201. The other side of the potentiometer 201 is connected to ground through an adjustable resistor 202. In a similar manner, the lead 200 is connected to one side of a potentiometer 203. The other side of the potentiometer 203 is connected to ground through an adjustable resistor 204. Thus, when the switch 196 is advanced to its other position, a selected DC voltage is impressed across the potentiometer 201 and when the switch 198 is advanced to its other position while the switch 196 remains in the position shown, a selected DC voltage is impressed across the potentiometer 203.

A voltage between zero and the selected voltage is impressed upon a lead 206 connected to the tap of the potentiometer 203 when the switch 198 is in its other position and the switch 196 is in the position shown. The lead 206 is connected through an inductance or choke 207 to the collector of a transistor 208, which is a part of the oscillator circuit 186. The emitter of the transistor 208 is connected to ground. The lead 206 is also connected through resistors 209 and 211 and a rectifier 212 to one side of a tickler coil 213. The rectifier 212 functions to reverse bias the base of the transistor 208 and is connected to one side of the tickler coil 213, which is excited by a tank circuit consisting of an inductance 214 and a condenser 216 coupled to the transistor 208 in which continuous oscillation is set up by the tank circuit. The other side of the tickler coil 213 is connected to the base of the transistor 208. The rectifier 212 establishes the reverse bias required by the base of the transistor 208 and is also connected to ground through a condenser 217 which establishes the bias network circuitry. A bias rectifier 2171 is connected between ground and a junction between the resistors 209 and 211. The tank circuit is connected with the collector of the transistor 208 through a coupling condenser 218. A condenser 219 is connected between the emitter and the collector of the transistor 208 to shunt out radio-frequency potentials. A capacitor 777 acts to provide a bypass to ground shunt for attenuating radio-frequency feed-back into the line 206 when the oscillating circuit 186 is in operation. The tank circuit can be tuned to oscillate at a rate of approximately 1.8 megaHertz. The oscillation is picked up by the transformer winding 1762 and the voltage thereof is multiplied by the transformer winding and impressed by way of the lead 179 on the control grid 168 of the tetrode 136 to provide an amplified output by the tetrode 136 of that frequency. The output of the tetrode 136 is impressed by way of a lead 220 on an output circuit which is coupled through condenser 221 to a tuned pie network which includes condensers 222 and 225 and inductances 223 and 226. Right-hand ends of the inductances 223 and 226 are connected to ground so that, if there should be failure of the condensers 221 and 222, the direct current output of the tetrode 136 would be drained off to ground without danger to a patient 70. A take-off lead 224 which is connected between the condenser 222 and the inductance 223 extends to one side of the condenser 225. The other side of the condenser 225 is connected to one side of a primary winding 501 of a transformer 502. The other side of the primary winding 501 is connected to ground. One end of a secondary winding 503 of the transformer 502 is coupled through a condenser 504 to a central lead 63 of the coaxial cable 18 and through a cable end assembly 53 to one end of a driver coil 28. The other end of the secondary winding 503 is connected to an outer conductor 68 of the coaxial cable 18. The other end of the driver coil 28 is connected through a condenser 49 to the outer conductor 68 of the coaxial cable 18. A passive electrode 22 is connected by a lead 522 to one side of a condenser 227. The other side of the condenser 227 is connected to the outer conductor 68. Thus, a continuous radio-frequency oscillating potential is set up in a driven coil 26 and in an active electrode 19, and an electrosurgical operation can be performed when the electrode 19 is advanced to the patient 70 mounted on a treatment table 71 with the passive electrode 22 engaging the patient. One end of the driven coil 26 is connected to the active electrode 19. The other end of the driven coil 26 is connected to the central lead 63 of the coaxial cable 18.

As long as the passive electrode 22 is coupled to the outer conductor 68 through the lead 522 and the condenser 227, a return path is provided for radio-frequency current, and, when the electrode 19 is brought close to or into engagement with the patient 70, an electrosurgical operation can be performed safely. However, if this coupling is broken as by electrical failure of the lead 522, the low impedance return path to the outer conductor 68 and the secondary winding 503 through the passive electrode is broken. As indicated by the dashed line 72, the surgical table can be at ground, and other items which can be connected to the patient can be at ground providing unwanted alternate return paths. A radio-frequency potential is developed between the ground 14 and the outer conductor 68 causing a radio-frequency potential to be set up in the transformer 17 and between the leads 23 and 24. This potential is rectified by a rectifier 74 to provide a direct current potential across the coil of the relay 31 to energize the relay 31. A condenser 76 mounted in parallel with the relay coil 31 smooths out the current to the relay coil 31. An adjustable resistor 77, which is connected in parallel with the relay coil 31, can be adjusted to determine the voltage at which the relay 31 is energized. When the relay 31 is energized, normally closed contacts 311 and 312 open and normally open contacts 312-313 close to disconnect the main low voltage direct current power lead 194 from the lead 321 to de-energize the switch 196 and to connect the main low voltage direct current power lead 194 to the coil of the relay 31 to maintain the relay 31 energized through a resistor 431 to ground. At the same time, normally open relay contacts 316-317 close to connect a buzzer horn 81 across the transformer leads 188 and 190 to cause the horn 81 to sound. A warning lamp 811 is connected in parallel with the horn 81 to provide a visible signal. The relay 31 is reset automatically when the main on-off switch 126 is turned to the off position to de-energize the transformer 130. Appropriate relay resetting mechanism of usual type can be a part of the relay 31 for resetting the relay when the relay 31 is de-energized.

When the on-off switch 126 is in its other or on position, the switch 198 is moved to its other position and the switch 196 remains in the position shown and a single pole double throw blend switch 2341 is in the off position shown, a continuous oscillation is impressed on the driver coil 28. When the switch 196 is moved to its other position and while the single pole double throw blend switch 2341 is in the off position shown, the oscillating circuit 184 is energized to produce an interrupted oscillation in the driver coil 28. The oscillating circuit 184 is generally similar to the circuit 186 already described and includes a transistor 237, a tank circuit inductance 238, a tank circuit capacitor 239, and a tickler coil 240 and associated elements. A lead 241, which is connected to the tap of the potentiometer 201, is connected through a choke 242 to the collector of the transistor 237. Moving of the switch 196 to its other position impresses a selected DC voltage across the potentiometer 201 and a DC voltage between zero and the selected voltage is impressed upon the lead 241. The emitter of the transistor 237 is connected to ground. The oscillating circuit 184 is set in operation to deliver an oscillator frequency of approximately 1.8 megaHertz on the control grid of the tetrode 136. The lead 199, which is connected to the high side of the potentiometer 201, is also connected through the pole of the blend switch 2341 to a lead 245, which is connected to base leads of transistors 244 and 246, which form a multivibrator circuit, through resistors 247 and 248, respectively. The collector lead of the transistor 244 is coupled through a condenser 249 to the base of the transistor 246 and the collector of the transistor 246 is coupled through a condenser 251 to the base of the transistor 244. The collectors of the transistors 244 and 246 are connected to the lead 245 through resistors 2511 and 2512, respectively. Emitters of the transistors 244 and 246 are connected to ground. The multivibrator circuit can be arranged to oscillate at a rate of approximately 7000 Hertz. A lead 252 from the collector of the transistor 244 is connected through a coupling condenser 253 and a rectifier 2531, and a resistor 2532 connected in parallel with the rectifier 2531, to the base of the transistor 237 so that the operation of the oscillating circuit 184 is interrupted at a rate of 7000 Hertz to put an interrupted oscillating potential on the control grid of the tetrode 136 and to supply an interrupted radio-frequency oscillating potential at the electrode 19. The rectifier 2531 and the resistor 2532 connected in parallel with the rectifier 2531 forms a network which preserves the wave form generated by the multivibrator circuit as it is transmitted to the oscillator circuit 184.

An adjustable capacitor 1765 is connected between the lead 179 and ground and can be adjusted so that it tunes with the transformer secondary coils 176 and 1762 and with the capacitor 2172 so tht the grid input is tuned with the plate series tuned circuit 222, 223, 225, and 226. Both of these circuits are tuned with the driver input oscillating circuits 184 and 186 at approximately 1.8 megaHertz.

When the blend switch 2341 is disposed in its other or "on" position, moving of the switch 198 to its other position while the switch 196 is in the position shown energizes both of the oscillating circuits 184 and 186. The oscillating circuit 186 is energized in the same manner as already described. The lead 200, which is connected to the switch 198, is connected through a lead 256, a rectifier 257, the blend switch 2341, the lead 245, and an adjustable resistor 2572 to the lead 199, which is connected to the right hand end of the potentiometer 201. The rectifier 257 prevents unwanted cross feed between the leads 199 and 200. A rectifier 2570 provides full direct current voltage to the multivibrator circuit associated with the transistors 244 and 246 when the direct current voltage dropping resistor 2572 is switched into the circuit, blend position, to maintain a constant voltage on the multivibrator circuit to insure stable operation. Both the oscillating circuit 184 and the oscillating circuit 186 are set in operation and an output is provided from the tetrode 136 for energizing the electrode 19 which combines the interrupted oscillation of the circuit 184 with the uninterrupted oscillation of the circuit 186.

The lead 245 of the multivibrator circuit is also connected to a sonic signalling device 271, which is constructed to produce a sound signal of a selected frequency, which can be 2900 Hz. The sonic signalling device 271 is connected to ground through a pole 2721 of an on-off switch 272 and a resistor 273. Similarly, the lead 200, which is connected to the high side of the potentiometer 203, is also connected to a second sonic signalling device 274, which is constructed to produce a sound signal of a second selected frequency, which can be 4500 Hz. The sonic signalling device 274 is connected to ground through a pole 2722 of the on-off switch 272 and a resistor 276. The sonic signalling device 271 sounds when the potentiometer 201 is energized to energize the oscillating circuit 184 to produce a sound signal which indicates to the user of the device that the oscillating circuit 184 is operating. The sonic signalling device 274 similarly produces a sound signal when the oscillating circuit 186 is energized to indicate that the oscillating circuit 186 is operating. When both the oscillating circuits 184 and 186 are operating, i.e., when a blended current is being produced, a sound signal is produced which is a blend of the selected frequencies. The rectifier 2570 insures a direct current voltage on the sonic signalling device 271 when the switch 2341 is in the blend (other or "on") position. If the user does not want sound signals, the on-off switch 272 can be opened. The resistance values of the resistors 273 and 276 determine the loudness of the sound signals.

The condenser 227, through which the passive electrode 22 is coupled to the return side of the secondary winding 503, permits passage of radio-frequency current to allow electrosurgical action but limits passage of lower frequency current which might shock the patient. The condenser 49, through which the driver coil 28 is coupled to the outer conductor 68, and the condenser 504 through which the central lead of the coaxial cable 18 is coupled to the secondary winding 503, similarly permit passage of radio-frequency current but prevent passage of lower frequency current generated as a subharmonic of the radio-frequency current to isolate the coils 28 and 26 from such lower frequency current to eliminate the so-called "faradic" effect or involuntary muscle contraction effect.

The electrosurgical device described above and illustrated in the drawings is subject to structural modification without departing from the spirit and scope of the appended claims. 

Having described my invention, what I claim as new and desire to secure by Letters Patent is:
 1. A radio-frequency electrosurgical device which comprises a radio-frequency generator, a power lead and a return lead, means for coupling the power lead and the return lead to the radio-frequency generator, an active electrosurgical electrode, means for coupling the power lead to the active electrosurgical electrode to power the active electrode, a passive electrode, means for coupling the passive electrode to the return lead, alternate path return means for coupling the return lead to ground at a point between the passive electrode and the radio-frequency generator, and means in the alternate path return means for indicating a predetermined radio-frequency return in the alternate path return means wherein the means in the alternate path return means includes a primary return path winding, and the device includes a secondary winding transformer coupled to the primary winding and a relay connected to and powered by the secondary winding.
 2. A radio-frequency electrosurgical device as in claim 1 wherein the device includes an alarm and the relay is connected to and operates the alarm.
 3. A radio-frequency electrosurgical device as in claim 1 wherein the device includes switch means for actuation by the relay to disable the radio-frequency generator.
 4. A radio-frequency electrosurgical device as in claim 1 wherein the means for coupling the power lead and the return lead to the radio-frequency generator includes an isolation transformer, the isolation transformer includes a primary winding coupled to the radio-frequency generator and a secondary winding coupled to the power lead and to the return lead, the device includes a first handpiece coil and a second handpiece coil, the power lead is coupled to one end of the first handpiece coil and to one end of the second handpiece coil, the other end of the first handpiece coil is coupled to the return lead, and the other end of the second handpiece coil is coupled to the active electrode. 